SANE-A study guide
SANE-A · Work through your exam, one topic at a time.
The Sexual Assault Nurse Examiner – Adult/Adolescent (SANE-A) credential is a professional certification for registered nurses who provide forensic-examiner care to patients aged roughly 13 and older after sexual assault, and for related patients such as those who disclose intimate partner violence, strangulation, or drug-facilitated assault. It signals that a nurse has met a knowledge standard beyond basic licensure: patient-centered, trauma-informed examination, injury identification and documentation, evidence collection and chain of custody, medical stabilization, pregnancy and STI/HIV prophylaxis, and the legal and courtroom responsibilities that follow. The SANE-A study guide has 8 sections and about 2,801 words.
01SANE Role, Scope of Practice, and Professional Issues
The SANE provides medically necessary care and conducts the forensic examination, but the two are not equal in priority: medical needs always outrank evidence collection. When a question presents a conflict between what law enforcement wants and what the patient needs or chooses, the answer favors the patient's informed choice and physiological safety.
357 words, about 2 min02Anatomy, Physiology, and Patient Assessment (Adult and Adolescent)
External female structures: mons pubis, labia majora and minora, clitoris and prepuce, vestibule, urethral meatus, Skene glands, Bartholin glands, hymen and hymenal ring, fossa navicularis, posterior fourchette, perineal body. Internal: vagina, cervix, uterus, adnexa.
324 words, about 2 min03Forensic Evidence Identification, Collection, and Preservation
Trace (fibers, hair, debris, glass, soil), biological (blood, saliva, semen, vaginal fluid, urine), impression and pattern evidence, digital/photographic documentation, and clothing. Deoxyribonucleic acid (DNA) is the most commonly adjudicated biological evidence, but trace evidence can corroborate or refute an account.
337 words, about 2 min04Trauma-Informed Examination, Injury Identification, Strangulation, and Medical Stability
Safety, trustworthiness, choice, collaboration, and empowerment. Explain each step before doing it, ask permission at each step, offer a support person, allow the patient to stop or pause, offer alternative positions, and never narrate findings in a way that implies judgment.
365 words, about 2 min05Prophylaxis, Treatment, and Follow-Up Medical Management
Pregnancy test, human immunodeficiency virus (HIV) testing with consent, syphilis serology, nucleic acid amplification testing for gonorrhea and chlamydia at exposed sites, trichomonas, hepatitis B and C serology, and vaccination status. Baseline results guide management and later interpretation.
387 words, about 2 min06Psychosocial, Cultural, and Behavioral Health Considerations
Acute stress reactions, fear, shame, self-blame, numbness, dissociation, and mistrust of systems. Any reaction is possible; composure is not evidence that nothing happened, and distress is not evidence that something did.
346 words, about 2 min07Legal, Ethical, and Judicial Proceedings Including Courtroom Testimony
Obtain informed, voluntary consent for examination, treatment, evidence collection, and release of information; document refusals and the patient's own words. Forensic records are still health records and are governed by privacy law and state rules, but subpoenas and court orders can compel disclosure - know the difference between a subpoena (often requires a response, sometimes a protective objection) and a court order, and route requests through counsel or the records department rather than releasing informally.
357 words, about 2 min08Documentation, Quality Improvement, and Evidence-Based Practice
Write objectively, chronologically, and contemporaneously. Record the patient's statements in quotation marks, describe findings anatomically with measurements and locations, include negative findings, and note consent, refusals, who was present, notifications made, and evidence disposition.
328 words, about 2 min